Homestead_Kruse (4),..,.,,
d� � t CLAIM FOR HOMESTEAD PROPERTY TAX .��
i��� CREDIT/STANDARD DEDUCTION
..��,�� State Form 5473 (R2 / 5-92)
-.,. .
INSTRUCTIONS: See reverse side loi liling instructions.
' FORM YEAR
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APR 2 8 �iy�o
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) occupied as our rincipal place of reside the following described real property for which a Homestead Pioperty Taz Credit is hereb daimed
�(We) owned ❑ Are buying,under contracl .
❑ Have a beneficial interest in the entity that is liable for ihe property taxes on the property and ihat owns ihe property or is buying under a contract.
� � . - � CONTRACT RECORDED � � - � -
If Wying on coniract, Fee Simple owner's name . ' . -
Recorders oHice where contract is recorded Record number Paqe
� � `� PROPERTY DESCRIPTION " � -
Counry .. . TownShip . -_.. Taeing di5[rict (ciry, to n, t w hip) � .
Parcel n�ber � �� �Leqal descriptio� , .� � � � _ � J / � � N „
.( lh • / 1 /_1,/ �
l JlJ I�CJ � � �
It any portion oi lhe residential SWCture or the land not exceetling one (7) ave that immetliatety surmunds that SlrucNre is used to produce income, descnbe the use and portion
of Ne property utilized to protluce income. . ,, .
�'G - /9-�,s �a-� �-�.S
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES .
Counry Township County
�eby certity the above statements are true, correct and complete. � n e ot dai �� n�
G�
Address (ny�qber arW streeL ciry. s(ate. ZIP cotle)
/A/ �/7G
ASSESSOR USE ONLY � TRUE TAX . ASSESSED HOMESTEAD NON-RESIDENTIAL
_ VALUE VALUE VALUE VALUE �
Land noi exceeding 1(one) acre immediately '
surrounding residential improvements. (�) ��
Otherland . (p�
Total Iand (line 1 plus line Z� (3)
. Dwelling (4) - � -
Residential improvements
Garage (5� -
Oiher improvements (6) �
Total improvements (line 4 through line � (7�
Total value Qine 3 pbs line � (g)
I hereby certify the above is Irue, CArrect, and Signature of Assessor Da;e signetl
complete.
�yirg action - Sgnature of Auditor Date signed
19_Pay79_ .
Lesser of t/2 Homesiead
Valuation or 52,000
STANDARD DEDUCTION
S
Datesig `�